Abstract
Depression and anxiety are highly prevalent disorders with an impact on existential aspects of person’s life, including employment i.e., work performance (WP). In order to develop appropriate strategies, it is essential to identify determinants of WP. The objective of this study was to identify the built, social, attitudinal and health system-related environmental determinants of WP in workers with anxiety or depression in total (N = 1211) and regarding the level of disability. Hierarchical binary logistic regression was performed on data obtained from implementation of the WHO Model Disability Survey (MDS) in Chile in 2015. Hindering aspects of means of transportation and workplace, and the use of personal assistance were determinants of WP for all workers with anxiety or depression. Results differed with level of disability. Hindering aspects of means of transportation and workplace, and discrimination were determinants of WP for persons with mild to moderate disability, while hindering aspects of the workplace and dwelling, and the use of personal assistance were determinants of WP for persons with severe disability. Our results emphasize the need for a broader understanding of determinants of WP and the requirement for an integrative approach in developing both universal and specific strategies that go beyond workplace settings.
Highlights
Depression and anxiety are highly prevalent groups of mental disorders that are costly and significant contributors to the global burden of disease
The main objective of this study is to identify the built, social, attitudinal and health system-related environmental determinants of work performance (WP) in workers with anxiety or depression, for the total sample and for subgroups taking into account level of disability
In comparison to individuals who considered the transportation facilitating, those who considered it as hindering had almost two times higher risk of experiencing problems in WP (OR = 1.977; 95% confidence intervals (95% CI) = 1.358–2.878)
Summary
Depression and anxiety are highly prevalent groups of mental disorders that are costly and significant contributors to the global burden of disease. Estimates on the lifetime prevalence of depression and anxiety range between 4–16.6% [1,2,3] and 3.8–25% [4], respectively. According to the Global Burden of Disease Study (GBD), depressive disorders were the third and anxiety the ninth leading cause of global disability in 2015 [5]. They are associated with the highest productivity-loss related costs of all chronic illnesses [6]. The total costs of depression in the European Union (EU) have been estimated at €118 billion per year, of which 64% are due to productivity losses [7]. The average annual costs, including medical, pharmaceutical and disability costs for workers with depression has been reported to be 4.2 times higher than those incurred by the usual beneficiary [8]
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